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Mechanisms of Hemostasis: Contributions of Platelets, Coagulation Factors, and the Vessel Wall

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Fundamentals of Vascular Biology

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Abstract

Hemostasis is a physiological process that allows rapid, localized, and highly regulated closure of an injured blood vessel while maintaining normal blood flow. It involves platelets (primary hemostasis), coagulation factors (secondary hemostasis), as well as components of the vessel wall. Upon vessel injury, circulating platelets rapidly adhere to the exposed subendothelial matrix, leading to platelet activation and concomitant release of secondary feedback molecules to stimulate and recruit additional platelets from the circulation. Direct platelet-platelet binding produces a platelet plug (white thrombus). In parallel, a cascade of coagulation factors is induced, which leads to cleavage and cross-linking of soluble fibrinogen into insoluble fibrin, forming a tight network transforming the initial, unstable platelet thrombus to a stable thrombus (red thrombus). Numerous positive feedback loops as well as anticoagulant mechanisms guarantee locally restricted coagulation at defined cellular surfaces and prevent excessive blood loss while ensuring vascular integrity and unrestricted blood flow. During wound healing processes, the thrombus is dissolved by the fibrinolytic system, which degrades fibrin and re-establishes physiological blood flow.

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Authors and Affiliations

  1. Department of Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria

    Marion Mussbacher, Julia B. Kral-Pointner, Manuel Salzmann, Waltraud C. Schrottmaier & Alice Assinger

  2. Department of Molecular Medicine and Surgery, Karolinska Institute and University Hospital, Stockholm, Sweden

    Julia B. Kral-Pointner

Authors
  1. Marion Mussbacher
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  2. Julia B. Kral-Pointner
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  3. Manuel Salzmann
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  4. Waltraud C. Schrottmaier
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  5. Alice Assinger
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Correspondence to Alice Assinger .

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  1. Department of Vascular Biology and Thrombosis Research, Center for Physiology and Pharmacology, Medical University of Vienna, Wien, Austria

    Margarethe Geiger

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Mussbacher, M., Kral-Pointner, J.B., Salzmann, M., Schrottmaier, W.C., Assinger, A. (2019). Mechanisms of Hemostasis: Contributions of Platelets, Coagulation Factors, and the Vessel Wall. In: Geiger, M. (eds) Fundamentals of Vascular Biology. Learning Materials in Biosciences. Springer, Cham. https://doi.org/10.1007/978-3-030-12270-6_8

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